Hepatitis C and diabetes: one treatment for two diseases?

Pattullo, Venessa; Heathcote, Jenny

doi:10.1111/j.1478-3231.2009.02185.x

Cited by 25 publications

(27 citation statements)

References 77 publications

(118 reference statements)

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“…Indeed, identifying patients who are at risk of developing diabetes, and have CHC, reduces liver disturbance progression [267,268] , the incidence of HCC and transplant-related morbidity and mortality. Additionally, this identification improves the response to antiviral therapy [269][270][271] , even reducing the side effects of the treatment [270] by encouraging the pretreatment of IR and DM [265] . Moreover, clinical trials on HCV-positive patients have reported improvement in glucose metabolism after antiviral treatment [187] .…”

Section: Prevention and Treatmentmentioning

confidence: 99%

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Hepatitis C virus infection and type 1 and type 2 diabetes mellitus

Antonelli

Ferrari

Giuggioli

et al. 2014

WJD

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cytokines, chemokines, and other immune-mediated mechanisms. Few data have been reported on the association of CHC and T1DM and reports on the potential association between T1DM and acute HCV infection are even rarer. A small number of studies indicate that interferon-α therapy can stimulate pancreatic autoimmunity and in certain cases lead to the development of T1DM. Diabetes and CHC have important interactions. Diabetic CHC patients have an increased risk of developing cirrhosis and hepatocellular carcinoma compared with non-diabetic CHC subjects. However, clinical trials on HCV-positive patients have reported improvements in glucose metabolism after antiviral treatment. Further studies are needed to improve prevention policies and to foster adequate and cost-effective programmes for the surveillance and treatment of diabetic CHC patients. AbstractHepatitis C virus (HCV) infection and diabetes mellitus are two major public health problems that cause devastating health and financial burdens worldwide. Diabetes can be classified into two major types: type 1 diabetes mellitus (T1DM) and T2DM. T2DM is a common endocrine disorder that encompasses multifactorial mechanisms, and T1DM is an immunologically mediated disease. Many epidemiological studies have shown an association between T2DM and chronic hepatitis C (CHC) infection. The processes through which CHC is associated with T2DM seem to involve direct viral effects, insulin resistance, proinflammatory Submit a

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Section: Prevention and Treatmentmentioning

confidence: 99%

“…CHC is a complex disease with systemic effects that require a multidisciplinary treatment approach [265] . The potential relationship between HCV infection and the development of DM increases the need for the implementation of prevention measures.…”

Section: Prevention and Treatmentmentioning

confidence: 99%

Hepatitis C virus infection and type 1 and type 2 diabetes mellitus

Antonelli

Ferrari

Giuggioli

et al. 2014

WJD

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“…However, DM is associated with both HCV and non-alcoholic fatty liver disease, which are associated with cirrhosis, an established risk factor for HCC [10,[20][21][22]. A study reported that DM in the presence of HCV infection increases the risk for HCC and DM mortality, with little evidence linking the increase in risk for HCC in diabetic patients with HBV infection [21].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for hepatocellular carcinoma in patients with chronic liver disease: a case–control study

Ahmed

et al. 2012

Cancer Causes Control

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The majority of data on risk factors (RFs) for hepatocellular carcinoma (HCC) comes from studies involving populations without underlying liver disease. It is important to evaluate RFs for HCC in patients with chronic liver disease since HCC rarely occurs in those without underlying liver disease. We conducted a hospital-based case-control study of 259 incident HCC cases and 781 controls by convenience sampling between 02/2001 and 12/2009 from the liver clinic at Stanford University Medical Center. The study population was 41% White, 14% Hispanic, 3% African American, 40% Asian American, and 2% other race/ethnicity. RFs were examined through medical records and an in-person questionnaire. Alcohol and tobacco use was calculated by cumulative grams of alcohol or cumulative pack(s) of cigarette consumed over one's lifetime. Diabetes mellitus (DM) was defined by random glucose level of ≥200 mg/dL. RFs were evaluated using multivariate logistic regression. Independent predictors of HCC risk, after mutual adjustment and additional control for alcohol use, etiology of liver diseases, and DM, included age >40 (OR = 8.5 [2.6-28.3]), male gender (OR = 3.5 [2.2-5.8]), presence of cirrhosis (OR = 2.8 [1.6-4.9]), Asian ethnicity (OR = 2.8 [1.8-4.6]), AFP > 50 (OR = 4.2 [2.6-6.8]), and cumulative lifetime tobacco use of >11,000 packs (OR = 1.7 [1.0-2.9]). Heavy prolonged cigarette smoking, but not alcohol use, was a significant independent predictor for HCC in patients with underlying liver disease. Besides older age, male gender, presence of cirrhosis, and elevated AFP, Asian ethnicity and heavy cumulative tobacco use are strong independent predictors of HCC.

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“…[7][8][9] Therefore, the development of novel diagnostic, prognostic and therapeutic tools that act early in attenuating key metabolic impairments of hepatogenous diabetes is urgently needed in biomedical research. [10][11][12] In recent years, increasing numbers of opinions in the fields of gastroenterology and endocrinology have specified IR (a state preceding the development of overt diabetes in which increased circulating free fatty acids impair insulin signaling in target tissues, resulting in excessive levels of blood insulin that are insufficient for achieving glycemic control 2,4 ) as a chief pathogenic determinant of hepatogenous diabetes and therefore an ideal target for therapeutic intervention. 8,9,[13][14][15] However, pharmacotherapies can be dangerous for liver disease patients, because these drugs may induce fatal metabolic burdens on the liver during their hepatic first pass.…”

Section: Introductionmentioning

confidence: 99%